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Introduction

Coconut water has become an increasingly popular sports drink because of its natural ingredients, electrolytes, and mineral content. Marketing has focused on the product’s low levels of fat, calories, and carbohydrates while promoting health benefits that are as-of-yet unproven. Coconut water, when consumed in excess, has been noted in case reports to cause severe hyperkalemia.1 We present a case of a 42-year-old otherwise healthy man who presented to our emergency department following an episode of exertional syncope after consuming multiple servings of coconut water.

Case Presentation

A 42-year-old black man without any medical history presented to our hospital after a syncopal episode. He was playing tennis outdoors all day in temperatures in excess of 90° Fahrenheit. He reported drinking a total of eight 11-ounce bottles of coconut water throughout the day. He experienced the sudden onset of lightheadedness and was witnessed to have lost consciousness. He did not experience any significant head trauma and regained consciousness almost immediately. Afterward he complained of generalized weakness and lightheadedness.